Perinatal anxiety and depression: what no one tells you about struggling during pregnancy

Everyone told you this would be one of the happiest times of your life.  And while some moments are, most of the time you just feel off. A feeling you can’t even describe properly, maybe sadness, maybe disconnected, almost  like you're watching everyone else's excitement from behind glass.  Your partner lights up talking about the nursery and is just so excited for this new chapter of your life,  your friends keep saying how lucky you are. And you know you're supposed to feel that way too, you're growing your baby inside you but  that feeling of excitement just won't come. And the longer it doesn't come, the more am fear starts to grow alongside it.  What if I never feel connected to this baby? What if something is wrong with me?  So you smile when people ask how you're feeling. You say "tired but good." You don't say the real thing because how do you say the real thing when everyone around you is so happy for you?   What  you're feeling has a name. It's more common than most people realize. And it is not your fault.   

What is perinatal anxiety and depression? 

Most people have heard of postpartum depression. The idea that after you have a baby, you might struggle emotionally... it's talked about, at least a little. But what a lot of people don't know is that anxiety and depression can also show up during pregnancy not just after.  Perinatal refers to the period that includes both pregnancy and the first year after birth. So perinatal anxiety and depression covers the full picture, the struggles that can show up at any point along the pregnancy journey, not just once the baby arrives.  Part of why this goes unrecognized so often is what we see around us. If we scroll through social media, pregnancy looks like glowing skin, cute bump photos, and partners crying happy tears at ultrasounds. Even friends barely open up about the harder part of their pregnancy... the fear, the sadness, the disconnection... that side rarely makes it into anyone's feed or conversation. So when you're experiencing it, it's easy to assume something is wrong with you and you are the anomaly.   You're not. Research from the Canadian Mental Health Association suggests that roughly 1 in 5 pregnant people will experience a mood or anxiety disorder during pregnancy, which is everything but rare.  

Depression during pregnancy symptoms: what to look for 

Depression during pregnancy is more common than most people realize. And it makes a lot of sense when you think about everything that's happening at once.  Your body is changing rapidly and your hormones are shifting in ways that are completely outside of your control. And depending on where you are in your pregnancy, you might be dealing with morning sickness, exhaustion, food aversions, or just a general feeling of being unwell physically. When you layer emotional struggle on top of it, it can feel completely overwhelming.  For a lot of people, depression during pregnancy shows up quietly. It's not always crying every day or feeling hopeless in an obvious way. Sometimes it looks like slowly withdrawing from the things that used to bring you joy. Maybe you were someone who worked out regularly and that movement was your outlet but now your body won't cooperate the way it used to. Maybe you were social and energetic, but now getting together with friends feels like too much. So you cancel. And then you cancel again.  Little by little, the things that kept you feeling like you start to fall away.   Common depression during pregnancy symptoms can include: 

• Persistent sadness or low mood that doesn't lift 

• Losing interest in things you used to enjoy 

• Withdrawing from friends, family, or your partner 

• Changes in appetite or sleep beyond typical pregnancy symptoms 

• Fatigue that feels heavier than just being tired 

• Feeling disconnected from your pregnancy or your baby 

• Difficulty concentrating or making decisions 

• Feeling like you're just going through the motions 

Some of these symptoms can overlap with normal pregnancy experiences, which is part of why depression during pregnancy gets missed so often. Feeling tired and nauseous is expected. But if you're also feeling empty, joyless, or like you're disappearing into yourself... that's worth paying attention to.   

Anxious pregnancy: what perinatal anxiety actually feels like 

Worry during pregnancy is normal. Of course you think about your baby's health. Of course you have moments of nervousness about labour, or parenting, or what comes next. That's human.  But perinatal anxiety is something different, it’s not a passing worry that comes and goes. It's a constant, relentless fear that something bad is going to happen and no amount of reassurance makes it go away for long.  For a lot of people, it shows up as an inability to switch off, your mind is always running. You might lie awake at night replaying every possible worst case scenario, or spend your days Googling symptoms and never feeling reassured by the results. The worry isn't proportionate to the situation. And you know that, somewhere. But knowing that doesn't make it stop.  The physical side of perinatal anxiety is real too, and it can be frightening on its own. Racing heart, Dizziness, Nausea, Chest tightness and some people experience full panic attacks. Your body is reacting as if there is a constant threat, because your nervous system is stuck in that heightened state.  And then there are the intrusive thoughts, thoughts about something happening to the baby. These thoughts can feel deeply shameful, which makes them even harder to talk about. But intrusive thoughts are a recognized symptom of perinatal anxiety, they don't mean you are a bad parent or that something is wrong with you as a person.  Common signs of an anxious pregnancy can include: 

• Intense, uncontrollable worry that's hard to reason with 

• Racing thoughts, especially about the baby's safety 

• Restlessness and an inability to relax 

• Severe insomnia or difficulty staying asleep 

• Panic attacks or a feeling that something terrible is about to happen 

• Physical symptoms like rapid heart rate, dizziness, or nausea 

• Intrusive thoughts about harm coming to the baby 

• Needing constant reassurance but never feeling fully reassured 

The emotional exhaustion of living in that state of fear... day after day, week after week... is hard to overstate. It is draining in a way that is difficult to describe to someone who hasn't experienced it.    

Why perinatal anxiety and depression often go unrecognized 

One of the biggest reasons perinatal anxiety and depression get missed is that so many of the symptoms look like... pregnancy.  Nausea, trouble sleeping, Fatigue, Worry about the baby are all common  things that happen to almost everyone who is pregnant at some point. So when you bring them up, to a doctor, to a partner, even to yourself, it's easy for them to get filed under "normal pregnancy stuff" and moved on from quickly.  And to be fair, some of it is normal. Worrying about your baby is normal. Feeling tired is normal. Feeling uncomfortable and restless in the third trimester is normal. The difference is the intensity, the duration, and the way it starts to take over. When the worry won't switch off,  the sadness doesn't lift or when you stop feeling like yourself and can't remember the last time you did... that's when it's moved beyond what pregnancy alone explains.  Mental health stigma is real. It exists in families, in communities and even in medical settings. Pregnancy adds another layer to it because there's this unspoken expectation that you should be happy, that you should be grateful, that struggling means something is wrong with you rather than something happening to you.  A lot of people also get told "it's just your hormones." And yes, hormones play a role. But that explanation, as well-meaning as it sometimes is, can minimize what someone is actually going through and delay them from getting real support.  You deserve more than "it's just hormones." What you're feeling is valid. And it has real, effective treatment options.   

What partners might notice and how to help 

Sometimes the person experiencing perinatal anxiety or depression doesn't have the words for what's happening to them. They just know something feels wrong. And in those moments, a partner can be the first one to notice that something has shifted.  You might notice your partner withdrawing, becoming quieter, Seeming disconnected from the pregnancy in a way that's hard to put your finger on. They might seem more irritable, or more tearful, or just... absent, even when they're right there with you. These can all be signs that they're struggling with something bigger than everyday stress.  If you're seeing these things, the most important thing you can do is show up without judgment.  This matters especially around some of the harder symptoms like a partner expressing that they don't feel connected to the baby, or that they're not as happy as they expected to be. Those feelings are already wrapped in so much guilt and shame. The last thing they need is to feel like they've disappointed you on top of everything else they're carrying. Your reaction in those moments matters more than you know.  That doesn't mean it's easy, it can be confusing and even painful to watch your partner struggle during a time you both expected to feel joyful. Those feelings are valid too but  try to remember, your partner is not  choosing to feel this way. And they're probably already being harder on themselves than you could ever be.  Some ways to support a partner going through this: 

• Listen without trying to fix. Sometimes they just need to feel heard, not problem-solved. 

• Learn the signs. The more you understand about perinatal anxiety and depression, the better equipped you are to recognize it and respond with compassion. 

• Encourage support gently. Suggest talking to a doctor or therapist without framing it as something being "wrong" with them. 

• Show up in small, practical ways. Taking something off their plate, reducing stress where you can, being present, these things matter enormously. 

• Don't take the withdrawal personally. Disconnection is a symptom, not a reflection of how they feel about you or your relationship. 

• Get support for yourself too. Watching someone you love struggle is hard. You don't have to carry that alone either. 

The most powerful thing a partner can offer is a safe place to land, somewhere without blame, without shame, and without pressure to feel differently than they do.   

When to reach out for support 

There's no perfect moment when reaching out for help becomes "allowed." You don't have to hit rock bottom first or even be sure or have the right words for  what you are experiencing.   But there are some signs that what you're experiencing has moved beyond something you should try to manage alone.  If the anxiety or depression is starting to take over your daily life... if you're struggling to function, to eat, to sleep, to show up for yourself or the people around you... that's worth talking to someone about. If you've stopped recognizing yourself or the worry or the sadness has become the background noise of every single day. If you feel like you're drowning and you can't find solid ground.  Those are signs that you deserve more support than you're getting right now.  Reaching out isn't giving up. It isn't failing at pregnancy or at being a parent. It's one of the most important things you can do, for yourself, and for your baby. You cannot pour from an empty cup, and getting support is how you start to fill it back up.   

We’re here if you need help 

At The Dot, we offer free consultations for anyone in Canada considering therapy. We’ll go through your questions and concerns and help you find the right therapist for what you’re dealing with.  Does everybody need therapy? No. But if you’re curious about working with someone who specializes in EMDR and trauma, that curiosity is worth pursuing.  Book Your Free Consultation  Visit our therapist match form to let us match you with the right therapist for your needs.